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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    The coronavirus lockdown has provoked a mental health crisis among the LGBTQ community, with younger people confined with bigoted relatives the most depressed, researchers found. A study of LGBTQ people’s experience during the pandemic, by University College London (UCL) and Sussex University, found 69% of respondents suffered depressive symptoms, rising to about 90% of those who had experienced homophobia or transphobia. Almost 10% of people reported they felt unsafe in their homes. The study called for more government support for LGBTQ charities, which have experienced significant rises in demand since the start of the pandemic. It warned: “Poor LGBTQ+ mental health may remain unchecked without a substantial policy commitment and funding directed to ameliorating health inequalities exacerbated by the pandemic.” Read full story Source: The Guardian, 5 August 2020
  2. News Article
    Patients suffering heart attacks during the coronavirus lockdown stayed away from hospitals with some dying as a result, a new study has found. In an analysis of more than 50,000 patients who suffered heart attacks and were treated in 99 NHS hospitals in England both before and after lockdown, researchers found the proportion of deaths for patients with a milder form of heart attack jumped during the first month of lockdown. Those suffering more severe heart attacks actually saw a lower death rate with hospitals keeping their emergency heart services running. Dr Jianhua Wu, associate professor in biostatistics at the University of Leeds and lead author of the study, said: “It has revealed that although patients were able to get access to high levels of care, the study suggests a lot of very ill people were not seeking emergency treatment and that may have been an unintended consequence of the ‘stay at home’ messaging.” Read full story Source: The Independent, 5 August 2020
  3. News Article
    MPs are to launch a new system for evaluating whether key health targets are being met in England. A panel of experts reporting to the Commons health committee will assess progress made on policy commitments, starting with maternity services. They will rate performance from "outstanding" to "inadequate" and seek to drive improvements where needed. Panel chair Dame Jane Dacre said it would be "fair and impartial" in its findings. She said she was keen to ask recent patients and users of NHS services to contribute to the panel's work as well as specialists in chosen fields, all of whom would have no political affiliation. "It will be challenging, but I am committed to using available evidence to evaluate pledges, with the aim of improving patient care," she added. The panel will scrutinise, on behalf of the health committee, major commitments made by the Department of Health, NHS England, NHS Improvement and other public bodies. It will base its approach on the Care Quality Commission, which evaluates care homes, hospitals, GP practices and other health services. Read full story Source: BBC News, 5 August 2020
  4. Content Article
    Many mental health service providers around England are meeting complex challenges with exceptional innovation, energy and creativity. NHS Improvement has drawn on this experience, skill and expertise to develop a national model to support continuous improvement in service delivery. This practical resource offers experience from those that have travelled the journey already, in the hope of supporting and encouraging other mental health trusts or any healthcare provider wishing to improve its services.  Chapter 7 looks specifically at safety, clinical audit and clinical governance. It shows that a structured approach to improvement supported by an open and just culture can make safer ways of working part of an organisation’s DNA. It recognises that organisations also need robust and transparent governance to keep services safe during major change.
  5. Content Article
    Accessing social care and social support services is key to support the well-being of people living with dementia (PLWD) and unpaid carers. COVID-19 has caused sudden closures or radical modifications of these services, and is resulting in prolonged self-isolation. The aim of this study from Giebel et al., published in Aging and Mental Health, was to explore the effects of COVID-19 related social care and support service changes and closures on the lives of PLWD and unpaid carers. Fifty semi-structured interviews were conducted with unpaid carers. The study found that PLWD and carers need to receive specific practical and psychological support during the pandemic to support their well-being, which is severely affected by public health restrictions.
  6. News Article
    MPs have launched an inquiry examining workforce burnout across the NHS and social care, and the system’s ability to manage staff stress amid increased pressures during the COVID-19 pandemic. The House of Commons health and social care committee said it aims to produce a report showing the levels of staff needed in health and social care to tackle exhaustion and meet future challenges. The committee is calling for evidence on how workforce shortages impacted staff well-being and patient care during the pandemic and the areas that need to see recruitment most urgently. Read full story Source: Pulse, 3 August 2020
  7. News Article
    People with chronic pain that can’t be explained by other conditions should not be prescribed opioids because they do more harm than good, the medicines watchdog has warned. The National Institute for Health and Care Excellence (NICE) has said people should instead be offered group exercise, acupuncture and psychological therapy. In new draft guidance, NICE said most of the common medications used for chronic primary pain has little or no evidence to support their use in patients aged over 16. Its latest guidance comes amid concerns over the level of opioid use. In September last year a review by Public Health England found 1 in 4 adults have been prescribed addictive medications with half of them taking the drugs for longer than 12 months. NICE’s new draft guidance said some antidepressants should be considered for people with chronic primary pain but it said paracetamol, non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen, as well as benzodiazepines or opioids should not be given because of concerns they might do more harm than good. Read full story Source: The Independent, 4 August 2020
  8. News Article
    New guidance requires GPs to offer at least some face-to-face appointments, amid reports that some had completely eliminated them, sparking ‘significant incidents’. NHS England’s instructions for the third phase of the NHS response to COVID-19 were issued on Friday, including the call that “all GP practices must offer face to face appointments at their surgeries” along with remote triage and remote consultations. Most appointments in primary care have been carried out remotely since the NHS instituted new operating procedures in response to covid, with practices offering a mix of remote consultations over the telephone or video, with a diminished number face-to-face. However, there have been reports of some GP practices not offering any face-to-face appointments at all, and continuing this approach following the peak of cases in the spring. A letter to GPs last month told them they must offer appointments in person “where clinically appropriate”, now reiterated in the phase three guidance. The letter added: “It should be clear to patients that all practice premises are open to provide care, with adjustments to the mode of delivery. No practice should be communicating to patients that their premises are closed.” Read full story Source: HSJ, 4 August 2020
  9. News Article
    The mother of a former patient at a north Wales mental health unit has said she "couldn't let" her daughter "go back there" as new details about people being "neglected" there have emerged. ITV News has seen a leaked copy of the Robin Holden report from 2014. It was commissioned by Betsi Cadwaladr Health Board after staff on the Hergest mental health unit, which is situated within Ysbyty Gwynedd in Bangor, blew the whistle over management and patient safety concerns. It reveals details never before made public, about how staff struggled to care for patients. The document, which the health board has fought for six years to keep out of public view, gives an account of the death of a patient while no doctor was available because of rota gaps, another of a patient who tried to take their own life, again when no doctor was available, and inadequate staffing affecting patient care. Read full story Source: ITN News, 31 August 2020
  10. Event
    until
    It has been a challenging year for the health and care sector, but the response to the COVID-19 pandemic has shown how technological innovation can bring about substantial improvement in efficiency of care. Join The King's Fund for this online event to learn about the proven benefits that technological solutions offer to complex problems, transforming the quality of care and patient experience for greater numbers of people. Using the orthopaedic pathway in Calderdale and Huddersfield NHS Foundation Trust as a case study, it will explore in depth how the adoption and integration of technology can help NHS trusts deliver on elective surgeries that were postponed due to the COVID-19 outbreak. Register
  11. News Article
    Today, four leading global organisations dedicated to fighting preventable deaths due to medical errors announced their partnership to co-convene the #uniteforsafecare programme on World Patient Safety Day (September 17, 2020). In June, the Patient Safety Movement Foundation announced the wide-ranging campaign to bring attention to system-wide improvements that will ensure better health worker and patient safety outcomes, called #uniteforsafecare. Now, the organisation will be joined by the American Society of Anesthesiologists (ASA), The Leapfrog Group, and International Society for Quality in Health Care (ISQua) in co-convening the slate of programming, which includes a virtual physical challenge to raise awareness of the issue; collaboration with the National Association for Healthcare Quality’s annual conference, NEXT; an in-person demonstration in Washington, D.C. and a free virtual event for the public and those who have experienced errors, harms, or death to themselves or loved ones. “As the first medical specialty to advocate for patient safety, and as physicians on the front lines treating COVID-19 patients, we know firsthand how critical ensuring health worker safety is,” said ASA President Mary Dale Peterson. “The issue is especially timely. From having the appropriate PPE to strategies for stress management and wellness – ensuring health worker safety is patient safety and improves outcomes. We are happy to participate in this effort to advance safety in health care.” Read press release
  12. Content Article
    The ideas and advice in this Improvement Leaders’ Guides from the Institute for Innovation and Improvement will provide a foundation for building and nurturing an improvement culture.
  13. News Article
    Two new tests for COVID-19 that are said to deliver results within 90 minutes are to be introduced across NHS hospitals and care homes, to speed up diagnosis ahead of winter and differentiate coronavirus infection from flu, the government says. But some experts were surprised by the government’s decision, saying the particular tests were not well-known. No data had been published concerning their evaluation. The government had made mistakes in buying tests that turned out to be sub-standard in the past, they said. “Repeatedly through the pandemic the government has raced ahead purchasing tests on the basis of manufacturer’s claims, and have found later when independent studies are done that the tests do not have adequate performance for use in the NHS,” said Professor Jon Deeks from Birmingham University, part of a team who have been evaluating tests of this sort. “We would hope that the government would wait for proper evaluations, and consider the scientific evidence for all available tests before signing further contracts. The mistakes made in test purchasing have wasted millions of pounds as well as put lives at risk.” Read full story Source: The Guardian, 3 August 2020
  14. News Article
    The proportion of patients confirmed as infected with COVID-19 after admission to East Kent hospitals is running at twice the national rate, according to figures seen by HSJ. The discovery comes as the Care Quality Commission confirmed to HSJ that it has sought and received further information from East Kent Hospitals University Foundation Trust on the high covid death rate at the trust. It is now deciding whether to take further action over the issue. Read full story (paywalled) Source: HSJ, 31 July 2020
  15. News Article
    Trusts have been set a series of “very stretching” targets to recover non-covid services to nearly normal levels in the next few months, in new guidance from NHS England. NHS England and Improvement set out the system’s priorities for the remainder of 2020-21 in a “phase three letter” sent to local leaders. It said the NHS must “return to near-normal levels of non-covid health services, making full use of the capacity available in the ‘window of opportunity’ between now and winter”, when further emergency and covid pressures are anticipated. In recent weeks providers have found it very difficult to resume many services, with many running at well below normal capacity, due to infection prevention measures, staffing gaps, and other covid-related barriers. The targets in the new guidance for phase three of the NHS’s covid response include: In September trusts must deliver “at least 80 per cent of their last year’s activity for both overnight electives and for outpatient/daycase procedures, rising to 90% in October (while aiming for 70% in August)”; “This means that systems need to very swiftly return to at least 90 per cent of their last year’s levels of MRI/CT and endoscopy procedures, with an ambition to reach 100 per cent by October.” “Trusts must hit 100 per cent of their last year’s activity for first outpatient attendances and follow-ups (face to face or virtually) from September through the balance of the year (and aiming for 90 per cent in August).” Read full story (paywalled) Source: HSJ, 31 July 2020
  16. Content Article
    NHS England and Improvement set out the NHS's priorities for the remainder of 2020-21 in a “phase three letter” sent to local leaders. 
  17. News Article
    A sponge-on-a-string pill test could transform the way oesophageal cancer is diagnosed, researchers say. The method can identify 10 times more people with Barrett’s oesophagus than the usual GP route, scientists say. The test, which can be carried out by a nurse in the GP surgery, is also better at picking up abnormal cells and potentially early-stage cancer. Barrett’s oesophagus is a condition that can lead to oesophageal cancer, cancer of the food pipe, in a small number of people. Normally it is diagnosed in hospital by endoscopy, which involves passing a camera down into the stomach, following a GP referral for long-standing heartburn symptoms. The cytosponge test, developed by researchers at the University of Cambridge, is a small pill with a thread attached that the patient swallows. It expands into a small sponge when it reaches the stomach, and is then quickly pulled back up the throat by a nurse, collecting cells from the oesophagus for analysis. The pill is a quick, simple and well tolerated test that can be performed in a GP surgery and helps tell doctors who needs an endoscopy. In turn, this could prevent many people from having potentially unnecessary endoscopies. Scientists say that as well as better detection, the test means cancer patients can benefit from kinder treatment options if their cancer is caught early enough. Read full story Source: The Independent, 1 August 2020
  18. News Article
    The list of lingering maladies from COVID-19 is longer and more varied than most doctors could have imagined. Ongoing problems include fatigue, a racing heartbeat, shortness of breath, achy joints, foggy thinking, a persistent loss of sense of smell, and damage to the heart, lungs, kidneys and brain. The likelihood of a patient developing persistent symptoms is hard to pin down because different studies track different outcomes and follow survivors for different lengths of time. One group in Italy found that 87% of a patient cohort hospitalized for acute COVID-19 was still struggling 2 months later. Data from the COVID Symptom Study, which uses an app into which millions of people in the United States, United Kingdom, and Sweden have tapped their symptoms, suggest 10% to 15% of people—including some “mild” cases—don’t quickly recover. But with the crisis just months old, no one knows how far into the future symptoms will endure, and whether COVID-19 will prompt the onset of chronic diseases. One such patient is Athena Akrami. Her early symptoms were textbook for COVID-19: a fever and cough, followed by shortness of breath, chest pain, and extreme fatigue. For weeks, she struggled to heal at home. But rather than ebb with time, Akrami’s symptoms waxed and waned without ever going away. She’s had just 3 weeks since March when her body temperature was normal. “Everybody talks about a binary situation, you either get it mild and recover quickly, or you get really sick and wind up in the ICU,” says Akrami, who falls into neither category. Thousands echo her story in online COVID-19 support groups. Outpatient clinics for survivors are springing up, and some are already overburdened. Akrami has been waiting more than 4 weeks to be seen at one of them, despite a referral from her general practitioner. Read full story Source: Science, 31 July 2020
  19. Content Article
    This is the final report of the accident on 1 June 2009 to the Airbus A330-203 registered F-GZCP operated by Air France flight AF 447 Rio de Janeiro - Paris. The investigation was carried out by the BEA, the French Civil Aviation Safety Investigation Authority.
  20. Content Article
    In this Episode of the 'This Is Nursing' podcast series, Gavin Portier speaks to with Alison Schofield, Tissue Viability Clinical Nurse Specialist from North Lincolnshire & Goole NHS Trust. Alison has worked in Tissue Viability since 2012 and during this time she has studied extensively in leading change in tissue viability, tissue viability management and leg ulcers. Alison discusses her role of a Tissue Viability Clinical Nurse Specialist and the challenges facing the role in this current world of nursing, the impact of COVID-19 has had on the delivery of community tissue viability services and on people in receipt of the services in care homes and in their own homes.
  21. Content Article
    The aim of this study from H R Guly was to describe the injuries misdiagnosed as a sprain of the wrist and to determine the approximate incidence of misdiagnosis in patients diagnosed as having a sprain of the wrist. In total 57 injuries initially diagnosed as a sprained wrist had a different diagnosis (1.76% of all diagnoses of sprained wrists). This is an underestimate of the true incidence of diagnostic error. Forty two per cent of the misdiagnoses were of greenstick or torus fractures of the distal radius. Guly concluded that training for junior doctors in A&E departments should be improved—especially training in radiological interpretation. Other methods of preventing diagnostic errors by misreading of radiographs, for example, more hot reporting of radiographs by radiologists or radiographers should be considered.
  22. Content Article
    The case contains useful guidance for practitioners, healthcare providers and commissioners concerning when an inquest into the death of a vulnerable person at a care home will engage Article 2 ECHR.
  23. Content Article
    This case will be of interest to capacity assessors, practitioners, healthcare providers and commissioners because it provides further guidance on the Court of Protection’s approach to capacity and best interests in relation to clinically assisted nutrition and hydration for victims of abuse and trauma.
  24. Content Article
    Data workbooks and explorer tool based on incidents reported by NHS providers in England to the National Reporting and Learning System (NRLS). Every six months the NHS publish official statistics as a breakdown by NHS trust of the incidents reported to the NRLS. The Organisation patient safety incident reports (OPSIR) provide data by NHS trust and gives NHS providers an easy-to-use summary of their current position on patient safety incidents reported to the NRLS. This includes information on patient safety incident reporting and the characteristics of their incidents. The information in these reports should be used alongside other local patient safety intelligence and expertise, and supports the NHS to deliver improvements in patient safety. As well as the OPSIR, the NHS also publish the National patient safety incident reports which set out the number of patient safety incidents reported to the NRLS from a national perspective and describe their patterns and trends.
  25. Content Article
    Animated video explaining why it is important to give feedback about the health and social care you receive in England
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